{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:12:53Z","timestamp":1785435173339,"version":"3.56.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"vor","delay-in-days":255,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nell W. and William S. Elkin Research Fellowship in Oncology"},{"DOI":"10.13039\/100011621","name":"Winship Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011621","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Emory University Hospital"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002378"],"award-info":[{"award-number":["UL1TR002378"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["TL1TR002382"],"award-info":[{"award-number":["TL1TR002382"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"Department of Veterans Affairs","doi-asserted-by":"publisher","award":["I01 RX001141"],"award-info":[{"award-number":["I01 RX001141"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Jordan Family Brain Tumor Initiative"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Resection of posterior fossa tumors (PFTs) can result in hydrocephalus that requires permanent cerebrospinal fluid (CSF) diversion. Our goal was to prospectively validate a machine-learning model to predict postoperative hydrocephalus after PFT surgery requiring permanent CSF diversion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We collected preoperative and postoperative variables on 518 patients that underwent PFT surgery at our center in a retrospective fashion to train several statistical classifiers to predict the need for permanent CSF diversion as a binary class. A total of 62 classifiers relevant to our data structure were surveyed, including regression models, decision trees, Bayesian models, and multilayer perceptron artificial neural networks (ANN). Models were trained using the (N = 518) retrospective data using 10-fold cross-validation to obtain accuracy metrics. Given the low incidence of our positive outcome (12%), we used the positive predictive value along with the area under the receiver operating characteristic curve (AUC) to compare models. The best performing model was then prospectively validated on a set of 90 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twelve percent of patients required permanent CSF diversion after PFT surgery. Of the trained models, 8 classifiers had an AUC greater than 0.5 on prospective testing. ANNs demonstrated the highest AUC of 0.902 with a positive predictive value of 83.3%. Despite comparable AUC, the remaining classifiers had a true positive rate below 35% (compared to ANN, P &amp;lt; .0001). The negative predictive value of the ANN model was 98.8%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ANN-based models can reliably predict the need for ventriculoperitoneal shunt after PFT surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/noajnl\/vdac145","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T11:10:14Z","timestamp":1663067414000},"source":"Crossref","is-referenced-by-count":2,"title":["Artificial neural networks predict the need for permanent cerebrospinal fluid diversion following posterior fossa tumor resection"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2159-8585","authenticated-orcid":false,"given":"David P","family":"Bray","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Miller","family":"Douglas","sequence":"additional","affiliation":[{"name":"Emory School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayton","family":"Grogan","sequence":"additional","affiliation":[{"name":"Medical College of Georgia-Augusta University , Augusta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem A","family":"Dawoud","sequence":"additional","affiliation":[{"name":"Emory School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Chow","sequence":"additional","affiliation":[{"name":"College of Arts and Sciences, Emory University , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Deibert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Pradilla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edjah K","family":"Nduom","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J","family":"Olson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali M","family":"Alawieh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly B","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"issue":"1-2","key":"2022102116374577200_CIT0001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF01400627","article-title":"CSF drainage in patients with posterior fossa tumours","volume":"117","author":"Taylor","year":"1992","journal-title":"Acta Neurochir (Wien)"},{"key":"2022102116374577200_CIT0002","doi-asserted-by":"crossref","DOI":"10.3171\/2018.8.JNS181005","article-title":"A novel grading system for the prediction of the need for cerebrospinal fluid drainage following posterior fossa tumor surgery","author":"Won","year":"2020","journal-title":"J Neurosurg."},{"issue":"5","key":"2022102116374577200_CIT0003","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s00701-018-3496-x","article-title":"Frequency and treatment of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients","volume":"160","author":"Marx","year":"2018","journal-title":"Acta Neurochir (Wien)"},{"issue":"3","key":"2022102116374577200_CIT0004","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/BF01456169","article-title":"Perioperative external ventricular drainage in obstructive hydrocephalus secondary to infratentorial brain tumours","volume":"96","author":"Rappaport","year":"1989","journal-title":"Acta Neurochir 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